Insurance Billing Services
File Paper and Electronic Claims
Most claims are filed electronically and we will work with clearinghouses to ensure claims are transmitted according to payer specifications. We will implement a process for sending secondary claims and review payer response reports to ensure claims are received by the payer. Total Billing Solutions (TBS) will file claims electronically or paper and ensure accurate and timely filing of secondary claims therefore increase your cash flow by maximizing first time acceptance of claims.
Statements or collection letters are sent on behalf of your practice or facility. The protocols of statements and collections are performed according to your specifications. You can customize statements and collection letters.
Electronically Post Payments
At TBS we will provide payment posting with automated feature that requires very little manual labor. We coordinate set-up with payers to ensure receipt of electronic remittances, retrieve electronic EOBs and set-up reason rules and payment guidelines to improve AR denial tracking, balancing each remit and provide an auditing process to ensure accuracy.
Verification of Benefits
Automation is key and therefore we will put the automated verification of benefits performed prior to appointment in conjunction with facility schedule. We will create registration and health history forms as well as coordinate online features for pre-registration process.
We will provide an evaluation of payer payment patterns and identify root causes. AR reports can be produced in a wide variety of ways to create the best snapshots of what is happening and where things need to be modified to achieve maximum results. A detailed and specific report outlining days in AR, what trends are discovered as well as what can be done to collect maximum dollars.
TBS will help assess denial patterns and trends in your practice and quantify the actual impact of denials. We will provide a detailed list of codes or procedures being denied and provide instructions as to how to resolve future denials.
Increase Payor Reimbursement
TBS will establish systems to assist personnel in the day to day collection of deductibles and co-payments. We provide instructions and system guides to personnel and train when appropriate to increase payer reimbursement and provide scripts as needed.
Because each practice is different,TBS will customize reports for you. Financial and operational reporting, including interpretation of data and implementation strategies, to improve financial and operational performance.
We electronically store and scan EOBS from payer.
We obtain the patient demographic data from the provider and input it in our system.
Our Medical Coders have vast experience in all specialties, including: Radiology, Emergency Medicine, Pathology, Cardiology, Otolaryngology and Dermatology to name a few. We are experienced with CPT, ICD-9, and HCPCS coding across all specialties, insurance and governmental requirements, and payer-specific coding requirements in the region.
At TBS we know how important benchmarks are and therefore we generate reports based on coding trends and compare data to other providers to determine if you are inline with others.
Unsure of the correct CPT code to use? Can’t find the right modifier? Submit us your coding question via email and we’ll get you the answer. Train all aspects of CPT, ICD9 and HCPCS codes, provide claim appeal letters claims with supporting documentation.
We review medical records to ensure that the documentation supports the service that was billed, ensuring that there has not been up or down coding.
To ensure that all that we discover can be corrected for good, TBS will provide education and training material specific to your specialty.
Charge Capture/Lost Revenue
At TBS we will ensure that all services that are performed are billed and make every visit a reimbursable service if at all possible. We review encounter forms and documentation to ensure that you are capturing all office charges, as well as set up access to hospital records to ensure capturing of all hospital charges.